Active NPI
Kathryn Ann Wagner, DPT
- Physical Therapist
- Augusta, GA
National Provider Identifier
1902044423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT008985
- Practice address
- 1305 Dantignac St
Augusta, GA 30901-2774 - Phone
- (706) 823-3807
- Fax
- (706) 823-3810
- NPI assigned
- Jan 22, 2009
- Last updated
- Jan 22, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT008985 | GA | Primary |
Addresses
Primary practice location
1305 Dantignac St
Augusta, GA 30901-2774
Mailing address
1305 Dantignac St
Augusta, GA 30901-2774
Phone (706) 823-3807
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT008985 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Rehabilitation, Fitness and Performance Center LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Aiken, SC
- NPI 1669909693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232582400000",
"number": "1902044423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 DANTIGNAC ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309012774",
"telephone_number": "706-823-3807",
"fax_number": "706-823-3810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 DANTIGNAC ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309012774",
"telephone_number": "706-823-3807",
"fax_number": "706-823-3810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "KATHRYN",
"middle_name": "ANN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-22",
"last_updated": "2009-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT008985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
- Srinivasareddy Vuyyuru, MD
- W S Flanagin Jr Inc (Hill Drug Company)
- Miranda Wade
- Robert Tyson Wade, MS.
- Kristen Waghorn, MS, CCC-SLP
- Keith Aloysius Wagner, PHARMD
- Deborah P. Wakefield, LCSW
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1293)
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1227)
- Wal-Mart Stores East LP (WalMart Pharmacy 10-4144)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.